HIT Workflow & Redesign Specialist: Curriculum Overview Component - Description Units - Description Appx. Time 1: Introduction to Health Care and Public Health in the U.S. Survey of how healthcare and public health are organized and services delivered in the US. It covers Healthcare reform and Meaningful Use topics. 2: The Culture of Health Care For individuals not familiar with healthcare, this component addresses job expectations in healthcare settings. It discusses how care is organized within a practice setting, privacy laws, and professional and ethical issues encountered in the workplace. 3: Terminology in Health Care and Public Health Settings This component explains specific terminology used by workers in healthcare and public health. 4: Introduction to Information and Computer Science: This component provides a basic overview of computer architecture; data organization, representation and structure, programming languages, networking and data communication, and basic terminology of computing. Units 1, 2 1: Healthcare reform: provides an overview of healthcare trends including evidence based medicine, quality and practice- care recommendations, comparative effectiveness research, and an overview of healthcare reform initiatives in the US. 2: Meaningful Use (MU): The HITECH (Health Information Technology for Economic and Clinical Health) Act of the American Recovery and Reinvestment Act (ARRA) legislated incentives for the meaningful use of health information technology. This unit describes the MU program, eligibility for incentive payments, and the criteria for achieving those payments in Stage 1 of the program. It also describes the standards specified for Stage 1 of meaningful Use, including those devoted to privacy and security. (Recent MU Updates will be addressed in fall conference.) Units: 1 4 1: An Overview of Healthcare: This introductory unit discusses some of the underlying concepts of health, culture, and how health informatics applications can be used to study culture. 2: Health Professionals The People in Healthcare: This unit discusses the health professionals who deliver healthcare and the training needed to work in these professions. 3: Healthcare Settings: This unit describes healthcare delivery sites and examines the structure, function, and interrelationship between healthcare settings. 4: Quality Measurement and Performance: This unit describes the concepts of quality measurement and performance improvement. The unit begins by setting the context of known quality problems in healthcare and then describes how quality is measured and efforts to improve it. This unit also discusses the role of information technology, incentives for quality improvement, and quality measurement under meaningful use. 1: Understanding Medical Words: This unit describes the meanings of medical words. 2: Public Health and Healthcare System Terminology: This unit describes public health. 3: What is Health Information Management and Technology? This unit describes health information management and technology 4: Electronic Health Records: This unit describes electronic health records (EHR). 5: Standards to Promote Health Information Exchange: This unit describes standards to promote HIE 1 6 1: Computer Software: This unit covers application and system software, with a focus on healthcare systems. It also describes the functions of operating systems, presents different operating systems, and defines the purpose and usage of file systems. 2: Computer Programming: This unit discusses the purpose and types of programming languages from simple machine code to high level programming languages, including the process of compiling and interpreting. Students will use variables, loops and conditional statements to build a simple program. Finally, this unit presents some advanced programming concepts such as Object Oriented Programming. 3: Databases and SQL: This unit discusses the purposes of databases, a relational database, and the querying 4 hours 3 4 hours 8 9 hours
5: History of Health Information Technology in the U.S.: This component traces the development of IT systems in healthcare and pubic health, beginning with the 1950 s and 1960 s and culminating in the HITECH act, including meaningful use of EHRs. 6: Health Management Information Systems: Introduction to health IT standards, health- related data structures, software applications; enterprise architecture in healthcare and public health organizations. 7: Working with HIT systems: Lab component where students will work with simulated systems and language SQL. Students will design a simple database using data modeling and normalization. This unit will define basic data operations, provide instruction on how to create common query statements, and discuss SQL implementation. 4: Networks: This unit covers the history and evolution of computer networks, including the various types of network communications. Various forms of networking addressing are also covered, including network topologies, standards and protocols, logical model concepts, network hardware, and wireless communication. 5: Security: This unit covers common security concerns and safeguards, including firewalls, encryption, virus protection software and patterns, and programming for security. Additional topics include security of wireless networks, and concern, mitigations, and regulations related to healthcare applications. 6: Information Systems: This unit defines information systems and describes how they are used. It discusses how an information system is designed, developed, tested, supported, and maintained. Finally it explains how information systems are used in healthcare settings, including the role of specialized information systems. 1: Evolution of Health IT: The Modern Era: This unit describes the evolution of health IT from 1990 s 2009. 2: Evolution of Health IT: The HITECH Act: This unit describes the background and provisions of the HITECH Act. 3: History of Electronic Health Records (EHRs): This unit describes the history of electronic health records. 4: History of CPOE and E- Prescribing: This unit describes the history of CPOE and e- prescribing. 5: History of Health Information Exchange: This unit describes the history of health information exchange. 1: Health Information Exchange: defines concept of information systems, characteristics, different types of systems and technologies supporting health care information systems. Also discussed in emerging trends, advantages and disadvantages. 2: Electronic Health Records: This unit defines EHR and EMR (Electronic Medical Record) and explains their similarities and differences. Also discussed in the governmental efforts related to HER systems including meaningful use and interoperable health information technology. 3: Computerized Provider Order Entry (CPOE): This unit defines and states the purpose for CPOE and explains how CPOE is being utilized in health care. The potential impact of CPOE as well as advantages and disadvantages are also addressed. 4: Clinical Decision Support Systems: This unit provides a definition of clinical decision support, historical context, requirements of a clinical decision support system, and relationships of clinical practice guidelines/ evidence- based practice to clinical decision support systems. Challenges and barriers in building and using clinical decision support systems are also addressed. 5: Administrative, Billing, and Financial Systems: This unit examines relationship of administrative, billing, and financial systems to the healthcare information system, explains applications needing integrated in health care information systems, explores health care organizations integration strategies, identifies the critical elements for integration of these systems, and discusses how health care organizations may gain valuable insights from integrated data through data analytics and trending. 1 8 1: Introduction and Overview: Components of HIT Systems: This unit discusses the core definitions and concepts of systems in general and healthcare specifically are presented. Using hands on exploratory lab exercises, 3 hours 4 hours 4 hours
data. Participants will play the role of practitioners using these systems to learn what is happening under the hood. 8: Networking and Health Information Exchange (HIE): In- depth analysis of data mobility including the hardware infrastructure (wires, wireless, and devices supporting them), the ISO stack, standards, internet protocols, federations and grids, the NHIN and other nationwide approaches. 9: Fundamentals of Health Workflow Process Analysis and Redesign: Fundamentals of health workflow process analysis and students will be introduced to an example HIT system where they will learn basic navigation and gain familiarity with components common to many clinical HIT systems. 2: Under the Hood: Functions of HIT Systems: Introduction to generic functions of HIT systems that underpin inpatient and outpatient processes. 3: Understanding Information Exchange in HIT Systems: Functional aspects of interoperability within and between systems. Applying didactically presented concepts to hands on lab assignments. 4: The Effective HIT System: designed to emphasize the aspects of HIT that contribute to effectiveness and meaningful use. The concepts of usability, consistency, and reliability in regards to HIT systems and how each contributes to, or detracts from, effectiveness will be presented. Definitions of evidence- based practice and guideline- enhanced care will be covered in addition to how HIT can support effective, safe, and efficient patient- centered care. 5: Fundamentals of Usability in HIT Systems What Does it Matter?: Basic concepts of usability in general and HIT usability specifically. Students will be exposed to usability bottlenecks and learn to identify usability roadblocks in the EHRs lab system, hypothesizing potential downstream effects of poor usability, and suggesting solutions/alternate designs. This unit will detail the relationships between usability, user satisfaction, and workarounds. 6: HIT Facilitated Error- Cause and Effect: Error in health and healthcare that can be facilitated and propagated by HIT. Difference classes of HIT errors (slips/mistakes, omission/commission) will be discussed and differentiated. 7: Protecting, Privacy, Security, and Confidentiality in HIT Systems: Overview of the concepts of privacy, security, and confidentiality of protected health information (PHI) in relation to HIT systems. Threats to PHI frequently encountered in HIT environments such as password sharing, offsite access to EHRs, challenges of staff turnover and student access, unauthorized access, etc. will be detailed. 8: Health IT in the Future: This unit will focus upon future directions for HIT. New areas of research and development in HIT will be examined. Students will gain a foundational understanding of these areas and will debate appropriateness and feasibility of new HIT development areas. 1: (ISO Open Systems Interconnection (OSI)): this unit addresses the OSI, including the purpose and content of each of its seven layers: physical, data link, network, transport, session, presentation, and application. Products, processes, protocols and tools at each level will be explained. Also in this unit is the flow of data through the models as data is transmitted and received by end devices. 2: (Basic Health Data Standards): This unit provides an orientation to the important data- related standards that enable interoperable health data interchange. 3: (EHR Functional Model Standards): This unit explores the functional requirements and standards for electronic health records (EHRs). 4: (Health Data Interchange Standards): This unit emphasizes the importance of adhering to health data interchange standards in order to ensure compatibility between systems. 5: (Health Information Exchange): This unit explores the networking standards and the standards required for interoperability to enable the creation of Health Information Exchanges. 1 7 1: Concepts of Processes and Process Analytics: This unit focuses on the six aims for health care process improvement. Students are helped to understand the concepts of systems, systems thinking and healthcare processes. Such understanding provides a foundation for the study if clinical process analysis redesign. 6 hours 6 8 hours
redesign is a necessary component of complete practice automation and includes topics of processes validation and change management. 10: Configuring EHR s: Provides a practical experience with a laboratory component (utilizing VistA for Education program) that will address approaches to assessing, selecting, and configuring EHRs to meet the specific needs of customers and end- users. 11: Quality Improvement: Introduces the concepts of health IT and practice workflow redesign as instruments of quality improvement. Addresses patient quality and safety management through electronic systems. 2: Interpreting and Creating Process Diagrams: Different diagraming methods. Interpret and create process diagrams. 3: Acquiring Clinical Process Knowledge: This unit covers the concepts and methods for acquiring clinical process knowledge in the health are setting needed by the health care Workflow Analysis and Redesign Specialist. 4: Process Redesign: This unit covers the methodology for process redesign in the health care facility. 5: Quality Improvement Methods: This unit covers Quality Improvement Methods recommended for use In the health care arena. This lesson creates awareness of the history, methods, and tools of quality improvement. 6: Leading and Facilitating Change: This unit introduces the concepts of change and the impact of such change on the providers and staff within a health care facility. It enhances the understanding that workflow analysts must be sensitive to the human component as they examine and propose modifications in processes. This unit prepares the student to recognize and address common change management problems, ad to work with individuals and groups to facilitate change. 7: Process Change Implementation and Evaluation: This unit helps students develop skills needed to implement and evaluate the effectiveness of changes designed to improve workflow processes and the quality of care in health care facility. 1: Patient Care Clinical Workflow; Multiple Perspectives of Patient Care (VistA Demo): introduction to patient care workflows in relevance to EHR implementation. Compares paper and EHR perspective and focuses on change management. 2: Building Order Sets: identifies the value of order sets as a quality control/improvement mechanism and an efficiency tool in clinical settings. Lab exercises will teach how to take treatment plans and implement them into specific order sets within VistA. 3: Creating Data Entry Templates (VistA Demo): lab and lecture about practical experience creating and using data entry templates. 4: Health Summary and Clinical Reminder Reports (VistA Demo): participant will learn attributes of quality information and engage in lab exercises creating Health Summary and Clinical Reminder reports two basic reports used in the EHR. 5: Meaningful Use and Implementation: describes the MU program of the HIT for HITECH Act of the ARRA from the vantage point of the VistA simulation EHR. Discusses the eligibility for MU incentive payments and the criteria for achieving them. 1 9 1: Intro. to Quality Improvement and Health Info. Technology: Introduces the concept of healthcare quality and the importance of MU of health IT improvement. 2: Principles of Quality and Safety for HIT: Introduces magnitude of the problem of medical error in the US health care system and the role of the learning in helping making our system safer. 3: Introduction to Reliability: Introduces learner to the notion of high reliability organizations. 4: Decision Support for Quality Improvement: In depth review of ways in which decision support can enhance quality and safety in patient care. 5: Workflow Design: Good practices for determining current workflow design and whether this design can be supported by HIT. Presents ways of assisting users to redesign clinical work- flow as needed without loss of quality and safety in the clinical environment. 5 hours
12: Public Health IT: Provides an overview of specialized public health applications and information exchange issues specific to public health. 13: Usability and Human Factors: Discussion of rapid prototyping, user- centered design and evaluation, usability; understanding effects of new technology and workflow on downstream processes, facilitation of a unit- wide focus group or simulation. 14: Working in Teams: experimental course that helps trainees become team players by understanding their roles, the importance of communication, and group cohesion. 15: Planning, Management, and Leadership for HIT: leadership principles and effective management of teams. Emphasis on leadership modes and styles best suited to IT deployment. 6: HIT Design to Support Teamwork and Communication: Focus on ways in which HIT can be designed to support care coordination, electronic tools supporting communication and teamwork during hand off, care planning, and care transitions. 7: HIT and Infecting a Patient Safety Culture: Specifics of how poor design and misuse of technology can place patients and organizations at risk with examples provided. 8: HIT Implementation Planning for Quality and Safety: Ways in which HIT implementation can be managed to ensure the quality and safety are maintained during the transition period. 9: Data Quality Improvement: Importance of data quality and the role of the HIT professional in monitoring and ensuring the quality of data in clinical information systems. 1, 2 1: Privacy, Confidentiality, and Security of Public Health Information: Apply health data definitions and standards, as well as privacy and confidentiality issues, in typical public health scenarios. 2: Public Health enabled EHRs and the Role of Public Health in HIE: Summarizes and describes the main role, functions, and applications of public health- enabled EHRs. 1 6 1: Requirements Engineering: Apply requirements engineering methods to inform design and technology selection. 2: Human Factors and Healthcare: Apply concept knowledge of human factors to the evaluation of systems- design and the study of human errors and patient safety. 3: Usability Evaluation Methods: Select the most appropriate usability evaluation method, given particular system, setting, and development phase. 4: Electronic Health Records and Usability: Apply principles of usability and design to critiquing EHR systems and to making recommendations for iterative improvement. 5: Clinical Decision Support and Usability: Diagnose problems associated with a clinical decision support system. 6: Designing for Safety: Diagnose various types of error and create or select potential solutions. 1: HIT Teams - Examples and Characteristics: Highlights different types of HIT teams and the purpose and functions of its members. 2: Forming and Developing a Team for HIT: Stages of team development: forming, storming, norming, and performing with the needs of the team identified at each stage. 3: Initial Tools for Teaming: Specific guidelines and rules associated with teams and working on an HIT team. 4: Team Strategies and Tools to Enhance Performance and Patient Safety: TeamSTEPPS methodology, to improve teaming skills, enhance communication across provider teams, and to seed a fundamental culture change. 5: Life Cycle of HIT Teams: Natural stages and structuring techniques in team development and the normative life cycles of teams. 1 4 1: The Management and Leadership Distinction: Describes the management and leadership distinction through the importance of developing and leading an HIT organization. 2: Effective and Ineffective Leaders: Describes the traits effective and ineffective leaders. 3: Overview of the IT Strategic Planning Process: Provides a high level of overview of the IT strategic Planning 7 hours 3 hours
16: Introduction to Project Management: An introduction and understanding of project management tools and techniques that results in the ability to create and follow a project management plan. Process 4: Change Management: Defines and describes the importance of change management and changing information technology in a group. 1 4 1: Overview of Health IT Projects: broad overview of project management including some distinctive characteristics of health IT projects. This unit includes several real scenarios to illustrate the diversity of projects in Health IT. 2: Project Life Cycles: Overview of various project life cycles so that students can assess their appropriateness for use depending on characteristics of a project. Students examine processes, knowledge areas, and organizational influences that are critical to successful project management. 3: Project Selection and Initiation: Participants learn what is necessary to get projects off to a strong start. Critical activities are to prepare a project charter and to identify and engage the project stakeholders. 4: Project Planning Overview: How to effectively plan projects and to develop a project management plan. Several key documentation components will be introduced. 3 4 hours Total: 16 components 82 units 64 69